| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
479 |
476 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
72 |
72 |
$739.44 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
243 |
234 |
$214.96 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
128 |
125 |
$132.22 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
180 |
173 |
$108.80 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$0.00 |